"We're running into a rash of this," said Dr. Franklin DiSpaltro, president of the American Society for Aesthetic Plastic Surgery.

"It scares me."

A handful of recent horror stories illustrate what many health officials say is a growing problem.

From California to New York

A doctor who had his medical license revoked in Riverside, Calif., was sentenced to more than 14 years in prison last month for performing illegal liposuction and breast augmentations that several patients testified caused pain and infection.

A 50-year-old woman testified that the doctor, Abdolvahab Steven Pirnia, was supposed to perform a 3-hour breast augmentation procedure, but it became an excruciating 8 ½ hour ordeal, with the implants rupturing twice, spilling onto her clothing. Another of Pirnia's patients — a 17-year-old girl — suffered infections after he performed breast implant surgery.

In Florida, Donnie "Viva" Hendrix and Mark Hawkins are on trial for unlicensed practice of medicine, manslaughter and third-degree felony murder. Police say a Miami secretary, Vera Lawrence, died in March 2001 after Hendrix and Hawkins injected industrial-grade silicon into her hips and buttocks. Medical examiners say the silicone entered Lawrence's bloodstream, leading to her death.

Several witnesses have come forward in the trial to allege Hendrix and Hawkins held "pumping parties" in a friend's apartment, where they would charge several hundred dollars for each illegal injection of silicone.

The FDA banned silicone injections for cosmetic purposes in 1991, although several clinical trials are testing ways to use it safely. The effects do not fade with time, as with collagen injections, but it can produce bumps and unattractive swelling.

The defendants' lawyer has claimed the witnesses in the case were unreliable.

In New York, prosecutors charged Eliezar and Iris Fernandez last month with impersonating physicians and injecting at least two people with an illegal Botox-like drug called Hyacell. The treatments left Freddy Borges, 47, hospitalized for months with a facial inflammation and infection, prosecutors claim. Another patient, Joan Lusk, 63, said she developed severe inflammations after receiving Hyacell injections in her face and hands.

New York state regulatory officials say such cases are on the rise, and a Florida health department investigator calls illegal silicone injections a "huge industry." Officials also say they are seeing more cases of unlicensed laser hair and tattoo removal.

Why Do They Do It?

These operations may seem obviously unsafe in hindsight, but experts say many people are too cavalier when deciding on plastic surgery. Embarrassment, desperation, the desire to save a buck, or excessive trust may send people to dubious cosmetic surgeons.

"We're all very susceptible to a non-licensed charlatan promising all sorts of things," said DiSpaltro.

In some cases, victims simply trusted their medical practitioner and never investigated their track record.

"They were bargain shopping, but they didn't know that he had a bad history," said Tim Johnson, senior investigator for the Riverside, Calif., district attorney's office, discussing the victims of Pirnia. "People tend to trust their doctors."